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Transcript

What distinguishes impulsive from non-impulsive suicides?

DR. CHARLES NEMEROFF: So one of the important issues to talk about is impulsivity. And sometimes impulsivity can be positive in the sense that one can impulsively be creative. And you know, having four children, I know about the ups and downs of adolescence. But it's always hard for parents to know when does adolescence become pathological?

And impulsivity is something to really worry about, uh, because it's associated with suicidality. So there are really two kinds of suicides that we generally see in patients with depression. One is the sort of classic notion that, I've been hopeless and helpless for so long. I'm hopeless that I'll ever be better, and I'm helpless to do anything about it, that patients unfortunately come to the erroneous conclusion that, "I might as well kill myself."

And those are people who are not impulsive. They write notes. They sort of say their goodbyes. They plan a suicide and they go ahead and do it. That's very different than the patient who is, at 3:00 in the morning, feeling horrible, can't sleep, is on the Internet and sends an email to their cousin saying, "You know, I was feeling pretty good an hour ago. And now this incredible blue haze has come over me, a severe cloud of melancholia. And I've decided to kill myself in the next five minutes. But I thought I'd say goodbye to you." And actually that is a true story. An adolescent sent this email to her cousin who then sent the email to the parents who went into her room as she was getting ready to commit suicide.